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MR-proAdrenomedullin as a predictor of renal replacement therapy in a cohort of critically ill patients with COVID-19.
Roedl, Kevin; Jarczak, Dominik; Fischer, Marlene; Haddad, Munif; Boenisch, Olaf; de Heer, Geraldine; Burdelski, Christoph; Frings, Daniel; Sensen, Barbara; Karakas, Mahir; Kluge, Stefan; Nierhaus, Axel.
  • Roedl K; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Jarczak D; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Fischer M; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Haddad M; Institute of Clinical Chemistry and Laboratory Medicine, University Medical Centre Eppendorf, Hamburg, Germany.
  • Boenisch O; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • de Heer G; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Burdelski C; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Frings D; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Sensen B; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Karakas M; Department of General and Interventional Cardiology, University Heart Center Hamburg-Eppendorf, Hamburg, Germany.
  • Kluge S; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Nierhaus A; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Biomarkers ; 26(5): 417-424, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1146879
Semantic information from SemMedBD (by NLM)
1. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Renal Replacement Therapy TREATS Cohort
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Cohort
4. Single organ dysfunction CAUSES intensive care
Subject
Single organ dysfunction
Predicate
CAUSES
Object
intensive care
5. Respiratory Failure CAUSES intensive care
Subject
Respiratory Failure
Predicate
CAUSES
Object
intensive care
6. Coronavirus Infections CAUSES COVID-19
Subject
Coronavirus Infections
Predicate
CAUSES
Object
COVID-19
7. Renal Replacement Therapy TREATS Critical Illness
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Critical Illness
8. Renal Replacement Therapy PREDISPOSES COVID-19
Subject
Renal Replacement Therapy
Predicate
PREDISPOSES
Object
COVID-19
9. Renal Replacement Therapy TREATS Patients
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Patients
10. Respiratory Distress Syndrom PROCESS_OF C0030705
Subject
Respiratory Distress Syndrom
Predicate
PROCESS_OF
Object
C0030705
11. Venovenous ECMO TREATS Patients
Subject
Venovenous ECMO
Predicate
TREATS
Object
Patients
12. Kidney Failur PROCESS_OF C0030705
Subject
Kidney Failur
Predicate
PROCESS_OF
Object
C0030705
13. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. Renal Replacement Therapy TREATS Cohort
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Cohort
16. Single organ dysfunction CAUSES intensive care
Subject
Single organ dysfunction
Predicate
CAUSES
Object
intensive care
17. Respiratory Failure CAUSES intensive care
Subject
Respiratory Failure
Predicate
CAUSES
Object
intensive care
18. Coronavirus Infections CAUSES COVID-19
Subject
Coronavirus Infections
Predicate
CAUSES
Object
COVID-19
19. Renal Replacement Therapy TREATS Critical Illness
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Critical Illness
20. Renal Replacement Therapy PREDISPOSES COVID-19
Subject
Renal Replacement Therapy
Predicate
PREDISPOSES
Object
COVID-19
21. Renal Replacement Therapy TREATS Patients
Subject
Renal Replacement Therapy
Predicate
TREATS
Object
Patients
22. Respiratory Distress Syndrome, Adult PROCESS_OF Patients
Subject
Respiratory Distress Syndrome, Adult
Predicate
PROCESS_OF
Object
Patients
23. Venovenous ECMO TREATS Patients
Subject
Venovenous ECMO
Predicate
TREATS
Object
Patients
24. Kidney Failure, Acute PROCESS_OF Patients
Subject
Kidney Failure, Acute
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

About 20% of ICU patients with COVID-19 require renal replacement therapy (RRT). Mid-regional pro-adrenomedullin (MR-proADM) might be used for risk assessment. This study investigates MR-proADM for RRT prediction in ICU patients with COVID-19.

METHODS:

We analysed data of consecutive patients with COVID-19, requiring ICU admission at a university hospital in Germany between March and September 2020. Clinical characteristics, details on AKI, and RRT were assessed. MR-proADM was measured on admission.

RESULTS:

64 patients were included (49 (77%) males). Median age was 62.5y (54-73). 47 (73%) patients were ventilated and 50 (78%) needed vasopressors. 25 (39%) patients had severe ARDS, and 10 patients needed veno-venous extracorporeal membrane oxygenation. 29 (45%) patients required RRT; median time from admission to RRT start was 2 (1-9) days. MR-proADM on admission was higher in the RRT group (2.491 vs. 1.23 nmol/l; p = 0.002) and showed the highest correlation with renalSOFA. ROC curve analysis showed that MR-proADM predicts RRT with an AUC of 0.69 (95% CI 0.543-0.828; p = 0.019). In multivariable logistic regression MR-proADM was an independent predictor (OR 3.813, 95% CI 1.110-13.102, p<0.05) for RRT requirement.

CONCLUSION:

AKI requiring RRT is frequent in ICU patients with COVID-19. MR-proADM on admission was able to predict RRT requirement, which may be of interest for risk stratification and management.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein Precursors / Critical Illness / Renal Replacement Therapy / Adrenomedullin / Acute Kidney Injury / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Biomarkers Journal subject: Biochemistry Year: 2021 Document Type: Article Affiliation country: 1354750X.2021.1905067

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein Precursors / Critical Illness / Renal Replacement Therapy / Adrenomedullin / Acute Kidney Injury / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Biomarkers Journal subject: Biochemistry Year: 2021 Document Type: Article Affiliation country: 1354750X.2021.1905067